Active NPI
Amelia Arevalo, M.D.
- Internal Medicine Physician
- Lake Havasu City, AZ
National Provider Identifier
1922105386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 10,926
- Practice address
- 2035 Mesquite Suite E
Lake Havasu VA Community Based Outpatient Clinic
Lake Havasu City, AZ 86403 - Phone
- (928) 445-4860
- NPI assigned
- Sep 20, 2006
- Last updated
- Jan 16, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 10,926 | PR | Primary |
Addresses
Primary practice location
2035 Mesquite Suite E
Lake Havasu VA Community Based Outpatient Clinic
Lake Havasu City, AZ 86403
Mailing address
4075 Vagabond Dr.
Lake Havasu City, AZ 86405
Phone (928) 505-8709
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121207000208 | AZ | Order and Referring Only - Internal Medicine | 9830341312 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10,926 | PR | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358294400000",
"number": "1922105386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4075 VAGABOND DR.",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "86405",
"telephone_number": "928-505-8709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2035 MESQUITE SUITE E",
"address_2": "LAKE HAVASU VA COMMUNITY BASED OUTPATIENT CLINIC",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "86403",
"telephone_number": "928-445-4860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AREVALO",
"first_name": "AMELIA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2013-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PR",
"license": "10,926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Havasu City, AZ
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- Arizona Arthritis & Rheumatology Associates P C
- Arizona Care Transport
- Arizona Coast Ear, Nose & Throat, LTD.
- Arizona Coast Radiology, PLLC
- Arizona Coast Wide Open MRI, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.